CT、MRI应用于直肠癌淋巴结转移术前诊断中的临床价值比较  

Comparison of clinical value of CT and MRI in preoperative diagnosis of lymph node metastasis of rectal cancer

作　　者：管文举 GUAN Wen-ju(Department of Radiology,Beijing First Hospital of Integrated Traditional Chinese and Western Medicine,Beijing 100018,China)

机构地区：[1]北京市第一中西医结合医院放射科,100018

出　　处：《中国现代药物应用》2024年第10期88-91,共4页Chinese Journal of Modern Drug Application

摘　　要：目的分析CT、核磁共振成像(MRI)应用于直肠癌淋巴结转移术前诊断中的临床价值。方法70例直肠癌患者,根据手术病理诊断结果分为恶性淋巴结组(淋巴结转移,49例)和良性淋巴结组(淋巴结未转移,21例)。患者手术治疗前均给予CT和MRI检查。比较两组CT、MRI影像学表现;CT、MRI对淋巴结转移的诊断效能。结果CT检查显示:良性淋巴结组淋巴结共76个,恶性淋巴结组淋巴结共388个。恶性淋巴结组的淋巴结数量、淋巴结大小、淋巴结短长径比分别为(7.92±1.44)个、(0.66±0.18)cm、(0.84±0.13),均高于良性淋巴结组的(3.62±1.58)个、(0.53±0.15)cm、(0.73±0.18)(P<0.05)。MRI检查显示:恶性淋巴结组的肠周脂肪混杂信号、静脉包绕征、浆膜面浸润检出率分别为71.43%、77.55%、61.22%,均高于良性淋巴结组的0、9.52%、23.81%(P<0.05)。将病理结果作为金标准,CT的诊断准确度、特异度、灵敏度分别为88.57%、80.95%、91.84%,均低于MRI的100.00%、100.00%、100.00%(P<0.05)。结论与CT检查相比,MRI检查在直肠癌淋巴结转移术前诊断中的准确度、特异度和灵敏度更高,能够帮助患者明确病情状态,为患者的手术治疗奠定基础。Objective To analyze the clinical value of CT and magnetic resonance imaging(MRI)in preoperative diagnosis of lymph node metastasis of rectal cancer.Methods 70 patients with rectal cancer were divided into malignant lymph node group(49 cases with lymph node metastasis)and benign lymph node group(21 cases without lymph node metastasis).All patients were given CT and MRI examinations before surgery.CT and MRI imaging findings were compared between the two groups.The diagnostic efficacy of CT and MRI for lymph node metastasis was compared.Results CT examination showed a total of 76 lymph nodes in the benign lymph node group and 388 lymph nodes in the malignant lymph node group.The number,size,and short aspect ratio of lymph nodes in the malignant lymph node group were(7.92±1.44)nodes,(0.66±0.18)cm,and(0.84±0.13),which were higher than(3.62±1.58)nodes,(0.53±0.15)cm,and(0.73±0.18)in the benign lymph node group(P<0.05).MRI showed that the detection rates of pericolonic fat mixed signals,venous wrapping sign and serous membrane infiltration in the malignant lymph node group were 71.43%,77.55%and 61.22%,which were higher than 0,9.52%and 23.81%in the benign lymph node group(P<0.05).Using pathological results as the gold standard,the diagnostic accuracy,specificity and sensitivity of CT were 88.57%,80.95%and 91.84%,which were lower than 100.00%,100.00%and 100.00%of MRI.Conclusion Compared with CT examination,MRI examination has a higher diagnostic rate,specificity,and sensitivity in the preoperative diagnosis of lymph node metastasis of rectal cancer,thereby helping patients clarify their condition and laying the foundation for surgical treatment.

关 键 词：CT 核磁共振成像 术前诊断 直肠癌淋巴结转移 应用效果 

分 类 号：R735.37[医药卫生—肿瘤] R445.2[医药卫生—临床医学]